| 蔡聪慧.降糖舒心方联合达格列净对慢性心衰合并2型糖尿病患者血管内皮功能、心肌细胞凋亡的影响[J].浙江中西医结合杂志,2024,34(12): |
| 降糖舒心方联合达格列净对慢性心衰合并2型糖尿病患者血管内皮功能、心肌细胞凋亡的影响 |
| Effects of Jiangtang Shuxin Fang and Daggligin on Vascular Endothelial Function and Myocardial Cell Apoptosis in Patients with Chronic Heart Failure and Type 2 diabetes |
| 投稿时间：2024-05-11 修订日期：2024-11-04 |
| DOI： |
| 中文关键词: 达格列净 降糖舒心方 慢性心力衰竭 2型糖尿病 血管内皮功能 心肌细胞凋亡 |
| 英文关键词:Dalglitazin Jiangtang Shuxin Fang Chronic heart failure Type 2 diabetes Vascular endothelial function Cardiomyocyte apoptosis |
| 基金项目:浙江省自然科学基金资助项目(LY13H020001) |
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| 中文摘要: |
| 【】目的:探究降糖舒心方联合达格列净对慢性心力衰竭(心衰)合并2型糖尿病患者血管内皮功能、心肌细胞凋亡的影响。方法:入选于我院2020年5月~2022年5月就诊的慢性心衰合并2型糖尿病患者92例,按随机数字表法分为对照组(46例)、治疗组(46例)。入组前所有受试者均给予常规降糖药物和标准心衰治疗方案,在此基础降糖方案基础上,治疗组加用降糖舒心方联合达格列净,连续治疗3个月。观察记录不良反应,并于治疗前后检测血清中血管内皮功能指标[6-酮-前列腺F1α(6-keto-prostate F1α,6-Keto-PGF1α)、血栓素2(thromboxane 2,TXB2)、内皮素(endothelin,ET)、一氧化氮(nitric oxide,NO)]以及心肌细胞凋亡相关分子[Caspase-3、可溶性凋亡相关因子(soluble apoptosis-related factor,sFas)、可溶性凋亡相关因子配体(soluble apoptosis-related factor ligand,sFasL)],采用6 min步行试验以及明尼苏达心力衰竭生活质量量表(Minnesota heart failure quality of life scale, MLHFQ)评估患者生活质量,同时对所有受试者进行为期6个月的随访,记录死亡和再住院发生率。结果:治疗后,两组MLHFQ评分、TXB2、ET-1以及Caspase-3、sFas、sFasL均呈降低趋势,且治疗组改善程度较对照组更明显(P<0.01),同时6-Keto-PGF1α、NO以及6分钟步行测试则成明显相反趋势,治疗组改善程度亦较对照组更明显(P<0.01)；此外,治疗组出现低血糖1例(2.17%),相较于对照组的8例(17.39%)显著更低,同时,治疗组因心衰恶化再入院有1例(2.17%),显著低于对照组的7例(15.22%),差异有统计学意义(P<0.05)。结论:对于慢性心衰合并2型糖尿病患者而言,降糖舒心方联合达格列净可以显著缓解其临床症状,提高整体治疗效果且安全可靠,其作用机制可能与抑制心肌细胞凋亡、改善血管内皮功能有关。 |
| 英文摘要: |
| Objective: To explore the effect of Jiangtang Shuxin Fang and dapagliflozin on vascular endothelial function and cardiomyocyte apoptosis in patients with chronic heart failure (heart failure) and type 2 diabetes. Methods: 92 patients with chronic heart failure and type 2 diabetes who were enrolled in Zhoushan Tird People’s Hispital from May 2020 to May 2022 were divided into control group (46 cases) and treatment group (46 cases) according to the random number table method. Before enrollment, all subjects were given conventional hypoglycemic drugs and standard heart failure treatment plans. On the basis of this basic hypoglycemic plan, the treatment group was additionally treated with Jiangtang Shuxin Fang combined with Dapagliflozin for three consecutive months. Observe and record the adverse reactions that occurred during the treatment. And before and after treatment, the indexes of vascular endothelial function in serum[ 6-keto-prostate f 1α (6-keto-pgf 1α) , thromboxane 2(TXB 2) , endothelin (ET) , nitric oxide (NO)], and the Nitric Oxide of apoptosis related molecules [ Caspase-3, soluble apoptosis-related factor (sFas) , and soluble apoptosis-related factor ligand (sFasL)] were measured. The quality of life of patients was evaluated by 6-minute walking test and Minnesota heart failure quality of life scale (MLHFQ). At the same time, all subjects were followed up for 6 months to record the incidence of death and readmission. Results: After treatment, the two groups of TXB2, ET-1, Caspase-3, sFas, sFasL and the MLHFQ score all showed a decreasing trend, and the improvement of the treatment group was more obvious than that of the control group (P<0.01). At the same time, 6-Keto-PGF1α, NO, the 6-minute walk test showed an obvious opposite trend, and the improvement degree of the treatment group was more obvious than that of the control group (P<0.01); In addition, 1 case (2.17%) of hypoglycemia occurred in the treatment group, which was compared with 8 in the control group. Cases (17.39%) were significantly lower. At the same time, 1 case (2.17%) in the treatment group was re-admitted to the hospital due to worsening heart failure, which was significantly lower than the 7 cases (15.22%) in the control group (P<0.05) . Conclusion: For patients with chronic heart failure and type 2 diabetes, Jiangtang Shuxin Fang combined with Dagelin can significantly alleviate their clinical symptoms, improve the overall therapeutic effect, and is safe and reliable. Its mechanism may be related to inhibiting myocardial cell apoptosis and improving vascular endothelial function. |
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